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Sommaires des Revues - The Lancet

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[Editorial] Tobacco control: a Foundation too far?  Voir?

Tobacco smoking is the leading cause of preventable mortality worldwide and is responsible for more than 7 million deaths each year. In today's issue of The Lancet, we publish a Viewpoint describing the mission and goals of the recently established Foundation for a Smoke-Free World, funded by tobacco giant Philip Morris International. Led by former WHO executive director Derek Yach, the Foundation, whose aim is “to eliminate cigarette smoking worldwide”, will receive US$1 billion in funding over the next 12 years.

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[Editorial] WHO launches new leadership, new priorities  Voir?

WHO's Director-General, Dr Tedros, last week launched his new cabinet to widespread acclaim. His mix of deputy and assistant director-generals is made up of nine women (two-thirds of his leadership team) with a geographical spread across 14 countries. India, Brazil, Saudi Arabia, South Africa, and Barbados are all newly represented. The announcement also translated Tedros's verbal promises into structural commitments. New priorities include Universal Health Coverage, climate change, and access to medicines.

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[Editorial] The link between cancer and obesity  Voir?

The US Centers for Disease Control and Prevention released a new report on cancer and obesity last week, highlighting that cancers associated with overweight and obesity, including thyroid, liver, kidney, and ovarian cancer, constitute 40% of cancers diagnosed in the USA, with over 630 000 diagnoses in 2014 alone. The study looked at data from the United States Cancer Statistics for 2005-2014. Disparities between sexes in the rates of cancers associated with obesity are especially stark, with 55% of all cancers diagnosed in women being associated with overweight and obesity, compared with only 24% of cancers in men.

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[Comment] The impact of IMPACT-AF  Voir?

We are living in an era when the science of medicine has never been better. Medical textbooks are regularly being updated and rewritten to accommodate advances. However, scientific advances are often not translated into medical practice or medical education. With a global burden in excess of 30 million people, atrial fibrillation could be considered a modern-day epidemic.1 But evidence shows that physicians considering anticoagulation treatments for patients are more influenced by the events they induce (bleeds) than the events potentially prevented, in this case devastating strokes.

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[Comment] Dual antiplatelet therapy guided by platelet function testing  Voir?

Oral P2Y12 receptor inhibitors are key for secondary prevention of atherothrombotic events in patients with acute coronary syndromes, in particular those undergoing percutaneous coronary intervention (PCI)1. Prasugrel and ticagrelor are more potent than clopidogrel, which is characterised by increased rates of high on-treatment platelet reactivity (HPR), a known marker for recurrent ischaemic events, including stent thrombosis.2 This characteristic could explain the greater reduction in atherothrombotic events, albeit at the expense of more bleeding, associated with prasugrel and ticagrelor therapy among patients with acute coronary syndromes undergoing PCI.

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[Comment] A hopeful therapy for Niemann-Pick C diseases  Voir?

Niemann-Pick C1 disease (NPC1) is a rare autosomal recessive lysosomal storage disease, which was separated from the sphinomyelinase-deficient NPCA and NPCB when cholesterol was found to be stored.1 No drugs for the disease are currently approved in the USA, although miglustat is approved in Europe. In The Lancet, Daniel Ory and colleagues2 report strong evidence that intrathecal delivery of hydroxypropyl-beta-cyclodextrin (HPBCD) slows the progression of NPC1.

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[Comment] Towards a smoke-free world? Philip Morris International's new Foundation is not credible  Voir?

Smoking causes more than 7 million deaths each year1 and tobacco companies have known, since at least 1950, that their products are lethal and addictive. Now Philip Morris International (PMI) is committing nearly US$1 billion over 12 years to the Philip Morris Foundation for a Smoke-Free World that will “fund scientific research designed to eliminate the use of smoked tobacco around the globe”.2 In a Lancet Viewpoint in this issue, the Foundation's President Derek Yach argues it will support “an unswerving focus…to improve public health and human wellbeing”.

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[Comment] Catastrophic medical insurance in China  Voir?

China's medical insurance system has changed dramatically in the past two decades. The country's most established programme, the Urban Employee Basic Medical Insurance, dates back to the mid-1990s and initially covered only 109 million employees of state-owned and collective enterprises.1 In the early 2000s, the Chinese Government established two additional insurance programmes, the New Cooperative Medical Scheme (NCMS) for rural residents and the Urban Resident Medical Insurance (URMI) programme for self-employed and unemployed urban residents.

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[Comment] Offline: Jim Kim finds his voice  Voir?

Jim Kim was an unexpected choice to lead the World Bank in 2012. He is not an economist (Kim is an anthropologist, physician, and health activist), and many Bank watchers were sceptical that he could lead an organisation full of econometricians. Kim's first term as President was tinged with controversy. Bravely—critics said unwisely—he embarked on a huge internal reform and cost-cutting programme. Soon, unhappiness inside the Bank became public, casting a shadow over his hopes for a fresh start at one of the world's most reviled development institutions.

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[World Report] The ACA after the expiry of the budget reconciliation  Voir?

After the latest repeal bill was withdrawn and the budget reconciliation has expired, what does the future hold for the ACA? Susan Jaffe, The Lancet's Washington correspondent, reports.
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[World Report] Nobel Prize awarded for discoveries in circadian rhythm  Voir?

The 2017 Nobel Prize in Physiology or Medicine was awarded to Jeffrey Hall, Michael Rosbash, and Michael Young. Talha Burki reports.
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[World Report] 2017 Roux Prize recipient announced: Samba Sow  Voir?

This year's Roux Prize was awarded to Samba Sow for using health data to save children's lives through a comprehensive vaccination programme. Andrew Green reports.
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[Perspectives] Jiang Baoguo: one, two, three against trauma in China  Voir?

To those who live in nations that count their population in tens rather than hundreds of millions, Chinese health and social statistics can be faintly unnerving. Major trauma, for example, accounts for more than 60 million visits annually to Chinese hospitals, and for 700 000–800 000 deaths. Many of these injuries are due to road traffic accidents—and car ownership in China has soared. One man long familiar with these figures is Professor Jiang Baoguo, President of Peking University People's Hospital and its Chief Physician, who is a co-author of a Review on transport and public health in China in this issue.

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[Perspectives] Spatial awareness  Voir?

How is your Klingon? The first scene of Star Trek: Discovery begins with a heated speech in the alien warriors' language. The Klingons are increasingly concerned about the incursion of Starfleet—the 23rd-century space exploration and defence service of the United Federation of Planets—into deep space. They don't like this human-heavy coalition, and they certainly don't trust it. The only words in English come at the climax of the scene, as the speaker quotes the distrusted “fatal greeting” of the enemy: “We come in peace.”

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[Perspectives] Doubt  Voir?

“You're sure?” she asks me. This is about the nasogastric tube, whether to remove it. Or—someone else, another day—if the biopsy's finally conclusive. Or the operation, to have it now or wait. Or CPR, whether to receive it.
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[Obituary] Sir David Todd  Voir?

Haematologist who transformed medical education and training in Hong Kong. He was born in Guangzhou, China, on Nov 17, 1928, and he died from pneumonia in Hong Kong on Aug 16, 2017, age 88 years.
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[Correspondence] Condemning industry attempts to subvert public policy for a tobacco-free world  Voir?

The World Heart Federation, alongside its partners in the Global Coalition for Circulatory Health, condemns outright the launch of the Foundation for a Smoke-Free World,1 which is a vehicle for the tobacco industry.
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[Correspondence] Nuclear war and public health: rebalancing priorities and global health leadership  Voir?

Recently, the North Korean nuclear and missile crisis has gripped international media headlines.1 In the streets of Seoul, the vast majority of civilians remain remarkably calm, confident that this threat will pass like those of the past. Yet, complacency would not serve an excuse in the face of war by either intention or tragic miscalculation. By then, the silence of the global health community will likely be seen as an opportunity missed. Why does it remain silent? Perhaps the community feels out of its depth in an area of competence of the UN Security Council—surely they must know what they are doing?

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[Correspondence] Charlie Gard and the limits of medicine  Voir?

The coverage of the Charlie Gard case in The Lancet (Aug 5, p 531)1 was excellent. As Dominic Wilkinson and Julian Savulescu wrote in their Comment,2 “we need a fair, expedient way of resolving disputes between families and clinicians”. But first, we need to acknowledge how rare such disputes are or, rather, how rarely they are not resolved at local level.

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[Correspondence] Severity of illness and the weekend effect  Voir?

In their Article (July 1, p 62),1 A Sarah Walker and colleagues reported that part of the so-called weekend effect can be explained using detailed biochemical, haematological, and other tests, which were absent in previous studies based on administrative databases.
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[Correspondence] Severity of illness and the weekend effect – Authors' reply  Voir?

In their letter, William J Kostis and Abel E Moreyra suggest that the poor availability of detailed data cannot explain all differences in outcomes between patients admitted at weekends and on weekdays. There is no intrinsic causal mechanism for a named day to lead to higher mortality risk and, therefore, some data clearly must exist that explain how the higher risk arises.

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[Correspondence] HPV vaccination in China needs to be more cost-effective  Voir?

Almost all cases of cervical cancer are caused by human papillomavirus (HPV). China accounts for about a third of the global burden of cervical cancer, with about 98 900 new cases of cervical cancer in China in 2015.1 After 10 years of the HPV vaccine being available in developed countries, HPV vaccines were finally approved in mainland China in 2016. On July 31, 2017, it was announced that HPV vaccines will gradually be made available in community health centres across 17 provinces.2

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[Correspondence] Medical education: what about the barefoot doctors?  Voir?

Medical education aims to cultivate effective and essential medical human resources for protecting people's health and the nation's sustainable development. On July 11, the State Council of China introduced bold plans to deepen the reform and development of medical education, which were summarised in The Lancet (July 22, p 334).1 Facing the increasing needs of health care and medical education, the Chinese Government is struggling to change the current situation and improve educational programmes, financial welfare, career promotion mechanisms, and ethical decision-making.

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[Department of Error] Department of Error  Voir?

Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015; 386: 1278–87—In this Article, the units for C-reactive protein concentration have been corrected to mg/L in the second sentence of the “Differentiation of simple from complex disease” section and in figure 2. The body temperature signs, low-risk Alvarado score, and high-risk AIR score have also been corrected in figure 2. These corrections have been made online as of Oct 12, 2017.

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[Department of Error] Department of Error  Voir?

GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1343–420—Data in Figure 5 have been amended. These corrections have been made to the online version as of Sept 18.

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[Articles] A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial  Voir?

A multifaceted and multilevel educational intervention, aimed to improve use of oral anticoagulation in patients with atrial fibrillation and at risk for stroke, resulted in a significant increase in the proportion of patients treated with oral anticoagulants. Such an intervention has the potential to improve stroke prevention around the world for patients with atrial fibrillation.

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[Articles] Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial  Voir?

Guided de-escalation of antiplatelet treatment was non-inferior to standard treatment with prasugrel at 1 year after PCI in terms of net clinical benefit. Our trial shows that early de-escalation of antiplatelet treatment can be considered as an alternative approach in patients with acute coronary syndrome managed with PCI.

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[Articles] Intrathecal 2-hydroxypropyl-β-cyclodextrin decreases neurological disease progression in Niemann-Pick disease, type C1: a non-randomised, open-label, phase 1–2 trial  Voir?

Patients with NPC1 treated with intrathecal HPβCD had slowed disease progression with an acceptable safety profile. These data support the initiation of a multinational, randomised, controlled trial of intrathecal HPβCD.
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[Clinical Picture] Generalised cowpox virus infection  Voir?

A 24-year-old man presented to our dermatology clinic with three haemorrhagic partially ulcerated nodules located in the right groin, surrounded by inflammation and oedema, which had evolved over the course of 1 week (figure), and fatigue. He had identical isolated skin lesions on the right shoulder, left knee, and left ankle. On examination he was febrile (temperature 38·5°C) and had tender generalised lymphadenopathy. He had no signs or personal history of atopy (atopic dermatitis, hay fever, asthma), although family history was positive for a sister with dermatitis.

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[Seminar] Neonatal sepsis  Voir?

Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal flora, or postnatal acquisition from the hospital or community.

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[Review] Transport and public health in China: the road to a healthy future  Voir?

Transportation-related risk factors are a major source of morbidity and mortality in China, where the expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside increased use of motorised transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect on air quality, but persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet and to famously congested roads.

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[Health Policy] Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents  Voir?

Investment in the capabilities of the world's 1·2 billion adolescents is vital to the UN's Sustainable Development Agenda. We examined investments in countries of low income, lower-middle income, and upper-middle income covering the majority of these adolescents globally to derive estimates of investment returns given existing knowledge. The costs and effects of the interventions were estimated by adapting existing models and by extending methods to create new modelling tools. Benefits were valued in terms of increased gross domestic product and averted social costs.

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[Viewpoint] Foundation for a smoke-free world  Voir?

The current and future health effects of smoking are well described. More than 7 million deaths per year are attributable to smoking, and projections suggest 1 billion deaths this century.1 Over a decade ago, in my role to facilitate the establishment of WHO's Framework Convention on Tobacco Control (FCTC), I warned about the potential for complacency in the years following the FCTC's adoption.2 We knew that implementation of the FCTC would take decades, and that it would be challenged from the outset by constrained funding, shifting priorities and political will, weak human and institutional capacity, and continuing opposition from the tobacco industry.

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Dernière mise à jour : 16/10/2017 : 12:47


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